Disseminated ulcers with sporotrichoid distribution

Abstract

A 56-year-old Filipino male presented to our outpatient clinic with a five-month history of cutaneous ulcerated nodules on the right knee and on the back of right foot which had treated previously been diagnosed and unsuccessfully as vascular ulcers. His medical history showed no treated relevant diseases or treatment. The patient had lived in Italy for many years, but frequently returned home to the Philippines. Cutaneous findingsSkin examination revealed multiple, non-tender, subcutaneous, warm and ulcerated nodules on the right lower limb with a sporotrichoid-like distribution and caseous discharge after squeezing (Figure 1a, b). Lesion size ranged from about 1 × 1 cm to 4 × 4 cm. Moreover, an ulcerated plaque attached to the subcutaneous tissue and ribs was present

Horse or Zebra?

“…Table 1 lists the most common elicitors in Central Europe [2][3][4][5]. In addition, other pathogens such as Mycobacterium tuberculosis may occasionally present in a sporotrichoid distribution [6]; however, infections with far more common pathogens can sometimes mimic a (pseudo) sporotrichoid spread [7], and considering common diseases first may avoid extensive diagnostic workups.…”